Amphetamine-Type-Stimulants (ATS) Use and Homosexuality-Related Enacted Stigma Are Associated With Depression Among Men Who Have Sex With Men (MSM) in Two Major Cities in Vietnam in 2014

ABSTRACT

Background: Men who have sex with men (MSM) are disproportionately affected by mental health concerns, including depression. Amphetamine-type-stimulants (ATS) use and homosexuality-related stigma and discrimination have been found associated with depression among MSM. Objectives: To assess the prevalence of depression and its associations with ATS use and homosexuality-related stigma and discrimination among MSM in Vietnam. Methods: 622 MSM were conveniently recruited in Hanoi and Ho Chi Minh city, Vietnam, from September to December 2014. We collected information on demographic characteristics, ATS, alcohol and other drug use, sexual behaviors, homosexuality-related and discrimination stigma, and sexual sensation-seeking. Depression and suicidal thoughts were assessed by the Patient Health Questionnaire (PHQ-9). We assessed associations of depression with ATS use and homosexuality-related stigma and discrimination using logistic regression. Results: Of 622 sampled MSM, 11.3% were classified as having major depression, 9.8% reported any suicidal thoughts in the last two weeks, 30.4% ever had used any ATS, 88.8% ever ad drank alcohol and 21.5% had ever used any other drugs. In multivariate analysis, depression was significantly associated with ATS use (Adjusted Odds Ratio [AOR: 2.20; (95% Confidence Interval (CI): 1.32–3.67], younger age of sexual debut with another man (AOR: 0.09; 95% CI: 0.02–0.50), and greater enacted homosexuality-related stigma (AOR: 1.97; 95% CI: 1.19–3.26). Conclusions: We found a moderate prevalence of depression among sampled MSM, which was associated with ATS use and enacted homosexuality-related stigma. We recommend integrating assessment and interventions regarding depression and methamphetamine use into gay-friendly, culturally adapted holistic HIV prevention for MSM in Vietnam.

KEYWORDS:

• Men who have sex with men
• amphetamine-type-stimulants
• homosexuality-related stigma and discrimination
• depression
• Vietnam

Acknowledgments

We acknowledge great support and inputs from staff of the Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi Centre of HIV/AIDS Prevention and Control, Center for Community Health Promotion, Center for Promotion of Quality of Life and leaders and representatives of community-based organizations of MSM in Ho Chi Minh City during data collection process in Hanoi and Ho Chi Minh City. Nga Thi Thu Vu contributed to the development of the research protocol, data collection, data analysis and the manuscript drafting and finalization. John de Wit and Martin Holt provided oversight supervision and valuable inputs for the whole process and the manuscript drafting and finalization. Huong Thi Thu Phan, Lan Thi La, Gioi Minh Tran, Tung Thanh Doan, and Trang Nguyen Nhu Nguyen provided input for the data collection and manuscript drafting and finalization.

Declaration of interest

The authors report no conflict of interest.

Funding

Nga Thi Thu Vu received Australian Award Scholarship for her PhD study in UNSW Australia. The study received financial support from the Faculty of Arts and Social Sciences (FASS), UNSW Australia under its Postgraduate Essential Research Program Funding scheme and External Research Program Funding schemes. The Centre for Social Research in Health is supported by funding from the Australian Government Department of Health. Funding agencies were not involved in the development of the research protocol, data collection, data analysis, interpretation or the dissemination of research findings.